In the course of the disease, people living with dementia may behave in an aggressive manner. A person may lash out, overreact or be verbally and physically abusive.
Coping with aggressive outbursts can be distressing for both caregivers, family and aged care staff.
It’s important to remember that changes in the brain cause personality and behavioural changes. Aggressive episodes may become more frequent due to the brains inability to control impulsive actions. A person with dementia rarely behaves aggressively on purpose.
Often a person’s behaviour may be related to an unmet need or an inability to communicate a need to a caregiver.
Sometimes people with dementia use aggression as a way to communicate. They could be in pain, frustrated or reacting to the physical environment.
For instance it’s only natural that a person feeling “locked up” in a dementia ward will become agitated and distressed when they feel they can not leave at will.
Aggression can be linked to fear or bad memories or it may simply be the only way the person feels they can let you know they are unhappy.
Often, the person with dementia is struggling to understand their surroundings. They may misinterpret things, or the people around them, and turn to aggression to defend themselves.
When a person living with dementia behaves in a way that is far from their usual selves, their behaviour could be related to something other than dementia. It can be easy to forget that those living with dementia often have several other health conditions that can affect their behaviour and wellbeing.
A sudden change in behaviour could be an indication that a person has a physical illness such as an infection, is in pain or reacting to medication.
Hallucinations and delusions can be associated with aggressive outbursts and bizarre behaviour. These kinds of outbursts could be related to medications or the physical environment. A very noisy environment can be disorientating and overstimulating for someone with dementia. Dark shadows may mean a person sees things that aren’t there.
Remember to always discuss changes in behaviour with a doctor. Behavioural symptoms can be extremely stressful for all concerned. As the disease progresses behavioural symptoms usually pass. Getting the right support will help you manage them.
Tips for managing aggressive behaviour
- Be alert to the warning signs of aggression, e.g increased agitation, pacing.
- Recognise the triggers to aggressive behaviour, e.g shower time, constipation, lack of sleep.
- Try to avoid confrontation. Be calm, use simple sentences and orientate the person to the environment and situation. Avoid using the word ‘no’
- Smile, remain non- confrontational and approachable.
- Distract their attention and recommend a walk or change in activity.
- Consider any unmet need they are trying to communicate, is a person in pain?
- Avoid overloading the person with complex tasks.
- Validate the person’s feelings and give reassurance.
- Try using music. Playing a favourite song during shower time or meals may help a person relax.